摘要:

AbstractFor 30 years the thyrotoxic patient has been subjected to a plurality of treatments by surgery, radio‐iodine and long term anti‐thyroid drugs. These therapies have been accepted as complementary to the needs of the individual patient, without regard for long term results or the economic situation as it affects both patient and hospital services. In the context of surgical treatment which is now available, it is suggested that the advantages of operation over other therapies presage a reversion to surgery as the treatment of cho

ISSN:0007-1323    

DOI:10.1002/bjs.1800620902

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractFrom 1959 to 1970, 272 operations for thyrotoxicosis were performed. Most of the patients received antithyroid drugs and thyroid hormones preoperatively. The patients were continuously followed up. The primary results with low morbidity and no mortality as well as the long term results with a low rate of recurrence and a relatively high incidence of thyroid substitution are discussed. A safe and effective programme for surgical treatment of thyrotoxicosis is described. Anti‐thyroid drugs and thyroid hormones should be administered as the method of choice in preparing these patients for surger

ISSN:0007-1323    

DOI:10.1002/bjs.1800620903

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractTwo cases of thyroglossal duct cyst carcinoma are presented and the world literature is reviewed. There are only 74 cases reported to date. In nearly all the cases the clinical diagnosis was thyroglossal cyst. Although the great majority of the tumours were papillary adenocarcinomas, 13.15 per cent were of other histological types. The treatment has been quite variable, but the most common initial treatment was Sistrunk's (1928) operation. Following the establishment of the diagnosis of malignancy, thyroidectomy was done in several cases, but it failed to show any evidence of malignancy in most of the thyroids removed, which establishes firmly the de novo origin of these tumours from the thyroglossal duct remnant. In only one case had tumour disseminated to distant organs, the lung, liver, etc. The scepticism as to whether some of the carcinomas associated with thyroglossal duct remnants may not in fact represent metastases from a small primary tumour of thyroid gland is examined. It appears that, though a possibility of primary or metastatic tumour in the thyroid does exist, the probability does not appear to be high. From our own experience it is suggested that local excision followed by radiotherapy, irrespective of recurrence, may be worth considering for the treatment of such carcinomas.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620904

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractTwo patients are described who presented with clinically solitary thyroid nodules which were found to be due to metastatic disease from the kidney and colon respectively. Removal of the solitary metastatis in one patient resulted in disease‐free survival for over 5 year

ISSN:0007-1323    

DOI:10.1002/bjs.1800620905

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractFifty patients with apparently “early” mammary carcinoma on clinical, radiological and biochemical grounds had a skeletal scintigram carried out when they first presented. Twelve (24 per cent) of the patients had a positive scintigram. All these patients have developed metastatic disease in the first 5 years following mastectomy, and at least 9 (75 per cent), and probably 10 (83 per cent), have died from mammary carcinoma during this period. This compares with 10 (26 per cent) of the patients with a negative scintigram who have developed recurrent or metastatic disease, of whom 8 (21 per cent) have died from their disease. Five years following mastectomy none of the patients with a positive scintigram was alive and free from disease, compared with 25 (66 per cent) of the patients with a negative scintigram.It would appear that skeletal scintigraphy is the most sensitive method of detecting skeletal metastases and of staging breast carcinoma at the moment. Where practicable, this investigation should be carried out before embarking upon treatment for any particular patient, and this certainly should become part of any clinical trial comparing different therapeutic regimens. However, before some of the newer bone‐seeking isotopes are used in this way, further studies are required to determine their false positive

ISSN:0007-1323    

DOI:10.1002/bjs.1800620906

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractOne hundred and fifty‐six successive patients have been admitted with the clinical diagnosis of acute cholecystitis and have been treated by operation on the next operating list. The diagnosis was correct in 154 and a diagnostic pathway has been determined. The clinical features, investigations, bacteriology and pathology are discussed.There is an increased need for choledochotomy in acute cholecystitis and this bile is more commonly infected than in the elective patient. It is suggested that those with infection can be identified prior to operation and should be treated with antibiotics on admission.The morbidity of operation on patients with uninfected bile is no greater than in those receiving elective surgery, and operative treatment is recommended for both groups of patient

ISSN:0007-1323    

DOI:10.1002/bjs.1800620907

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractA 15‐year follow‐up of 57 patients who underwent portocaval anastomosis is reported. Twenty‐seven patients were still alive and the progress of these and of those who died is followed.The young cryptogenic cirrhotic with no encephalopathy, normal liver function tests and absence of portal vein mural thrombus at the time of operation is best benefited.The only factor from the series to suggest a poor prognosis is deterioration in liver function in the postjaundice cirrhotic, and the development of encephalopathy in cryptogenic cirrhotics suggests a poor long term prognosis, but its onset is not related to the time before

ISSN:0007-1323    

DOI:10.1002/bjs.1800620908

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractThe acute effect of intravenous and intragastric alcohol on exocrine pancreatic secretion was studied in pigs with chronic pancreatic and gastric fistulas. A new H‐type pancreatic cannula was designed for the study.With intravenous alcohol and the gastric fistula open, increased gastric acid secretion occurred but pancreatic enzyme output was inhibited. When acid was allowed to enter the duodenum by closing the gastric fistula, intravenous alcohol produced a secretin‐like effect of increased pancreatic volume and bicarbonate secretion.Intragastric alcohol caused an increase in volume, bicarbonate and enzyme output. This was probably due initially to direct gastroduodenal stimulation as the same response occurred following intragastric mannitol of similar volume, pH and osmolality. The subsequently sustained increase in volume and bicarbonate was possibly a secondary secretin‐like response following absorption of alcohol.It is concluded that the pig pancreas responds to alcohol as has been described in other animals. The use of a single model has allowed clarification of various phases of response invoking the effects of secretin, gastric and glu

ISSN:0007-1323    

DOI:10.1002/bjs.1800620909

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractAnticoagulation with heparin may not always adequately protect an ischaemic vascular bed. A screen filtration device has been employed to study the in vitro actions of acid‐citrate‐dextrose (ACD) and heparin on blood from the dog in haemorrhagic shock. With both anticoagulants, blood obtained during shock caused greater filter obstruction than blood taken before shock. However, the increased obstruction was nearly four times greater with heparinized blood than with acid‐citrate‐dextrose blood. These findings suggest that the anticoagulant action of heparin may be markedly diminished in low blood flow

ISSN:0007-1323    

DOI:10.1002/bjs.1800620910

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractA disease characterized by segments of ischaemic small intestine has been recognized in northern Thailand over the past decade. The clinical features and appearance of the diseased intestine are described. Most of the patients were treated by surgical resection of the affected bowel. The overall mortality was 14 per cent. Recently, some patients have been successfully treated by non‐surgical means. The aetiology of the disease is still unknow

ISSN:0007-1323    

DOI:10.1002/bjs.1800620911

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY